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E.17M 22-02-005 . ev 12 04. <br />RECYCLED ANTIFREEZE <br />N/A <br />_ <br />NON HAZARDOUS WASTE LIQUID <br />TnUC:K TIME <br />N/A <br />GREASWEEP <br />N/A <br />I hereby certify that I have no mixed thi-. wnste with any oilier wmme, tt'w i the total halfdes are lest; than 1000 F.F.M.; and that <br />to the char. es for legal disposal if this waste is over <br />r <br />Any 4 9 9$ p"f'� <br />the waste does not rontnin a P.0-e.'s I further a. rep Fccept additional <br />TOTALL& <br />x- <br />1000 P. P.M. total halides, or,r ontWnes a P.C.B.'s. <br />DRIVER GENERATOR/AUTHORIZ D - <br />SIGNATURE SICNATURI� SIGN fUR <br />; , ..•�;,�; ...�„-.' --- �` <br />TERMS: 1NV0I0E1,OVE 30 bAY ARE SUBJECT TO A 1.5% SERVICE CHARGE. CUSTOMER XG-FTEES TO PP AI_,I_ f eGAL FEES 1F <br />COURT ACTION BECOM S NECESSARY TO COLLECT THIS INVOICE. <br />Amprionn Vnliey Waste. Oil h . reby 7dvis • s tile; above Generator the Generators Shipment of used oil may be transported to a facility that, is required to comph <br />with federal regulations appli able tom. nagement of used oll, but that Is not requiro(i to comply with the more stringent requirements applicable to hazardous <br />waste managomont faclifti6s. California fnellilles that handle or process used oil are required to meet those more stringent requirements, and some out -of <br />state facillites that process t sad oil also meet those rcouirements, enginoering certifications of tank Integrity, and flnanoial assurances for closure am <br />accidental releases. It Is 1nw ul to semi used rill to out-of-state fnrilities that comply only with fedorel used oil management standards Fancl not these more <br />stringent rPqulrnr71ehT& <br />This nndfirntinn is for informf tion perp es only, ! <br />Driver signed.., - — _.. 4 Date �' Generator. sfkpd-.,.r :" �_ C%+I� �"..'� <br />-----..: <br />By slgnlnrt rhn invofra the g n `ator'c , .tiles that the g nera(or I as'eslflhllshcd a progrfrMOo *6& de tiid'votume or -quantity and toxicity, df tii4 h - I,- u: <br />wnstP. to ttte rlegree, as det.r•. trined l7y he gP.nera+tnr, to b' i:condmicaily praotfc�bir•: <br />By both parties signing this i voice it vol t serve as An agreement that American Valley %bill submit confirmations for (certain waste streams) to the generatc <br />that their waste haS hopn im sported tr a licenso treatment or Iransfer facility, <br />DISP SAL RECYgL 112 FACILITY: <br />Q RIVFr; RANK pll_ IRAN 3FEIR O RAMOS ENVIRONMENTAL SERVICES <br />5300 CLAD. ROAD - RIVEnSANK, CA f' 6367 1515 SOUTH RIVER ROAD - W, SACRAMENTO, CA 95691 <br />209-863-811A I • EPA •t? AI-000Igb816 916.371.•5747 • FPA tk CAD044003556 <br />ti+f r <br />